HCS, LLC Review of Managed Care Payments

Healthcare Consulting Services, LLC (HCS), has found that with the complexities of most managed care contracts it is not uncommon for payments to be calculated incorrectly.

Typical errors include:

	Payment for the incorrect grouping
	No payment for outliers
	Payment from expired contract rates
	No payment for items not included in group rates

HCS will conduct a feasibility analysis to determine the scope of incorrect payments from managed care payors. The analysis will include major payors and those with complicated payment schemes to project an estimate of potential recoveries.

The main goal of the analysis is to identify incorrect payments, to recommend corrective actions and procedural modifications and to provide information and strategies to optimize reimbursement and future contract negotiations.

Other problem areas typically identified include:

	Outpatient and Inpatient Coding
	Contract Negotiation

If you would be interested in a review of your managed care payments or have any questions, please call Grant Byers at (317) 633-4708, Ext. 316 or e-mail at gbyers@hcs-healthcare.com.

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